Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles.
Steve R Fisher, Addie Middleton, James E Graham and 1 others
PMID 29428342WHAT IT FOUND
Among Medicare inpatient rehabilitation discharges classified as needing no physical assistance by FIM summary scores, about one quarter still needed help on at least one item.
Stairs, lower-body dressing, bathing, and tub transfers were common.
Key findings
01About one quarter of patients classified as needing no physical assistance still required help on at least one item.
02The items with the most assistance needs were stair climbing (20.4%), lower extremity dressing (16.2%), bathing (13.8%), and tub transfers (6.1%).
03The same summary score can be obtained through multiple different item patterns.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The analysis used administrative Medicare files, so it cannot confirm how consistently or accurately FIM data were entered. The cohort excluded short stays, deaths, discharges against medical advice, and facilities with fewer than 20 discharges, so it describes only patients discharged from included inpatient rehabilitation settings.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume a high FIM summary score means the patient is independent on every daily task. The paper found that some patients classified as needing no physical assistance still needed help on at least one item.